Tagawa髋臼旋转截骨术治疗髋臼发育不良的评价

Evaluation of Tagawa's Rotational Acetabular Osteotomy for the Treatment of Congenital Acetabular Dysplasia

目的 评价Tagawa髋臼旋转截骨术治疗髋臼发育不良的临床效果。方法 采用Tagawa髋臼旋转截骨术治疗髋臼发育不良 ,用Harris评分和测量X线髋臼指数来评估手术的临床效果和髋臼 股骨头解剖关系的变化。结果 Harris评分从术前的平均 ( 80± 7.7)分提高到 ( 95± 1.8)分 ,主要表现为疼痛明显改善。X线显示髋臼CE角、AC角、AHI获得明显改善 ,但HLI没有变化。所有病例没有重大并发症发生。结论 Tagawa髋臼旋转截骨术治疗髋臼发育不良能较好地重建髋臼和股骨头的解剖关系 ,可以明显改善患者髋部疼痛症状 。

Purpose: To investigate the clinical results of Tagawa's rotational acetabular osteotomy for congenital acetabular dysplasia. Methods: 22 hips with congenital acetabular dysplasia and pain were treated by rotational acetabular osteotomy according to Tagawa's method. All patients were reviewed clinically and radiologically at a mean of 5.4 years follow-up after operation. Results: The harris hip score was improved from an average of (80 ± 7.7) points preoperatively to an average of (95 ± 1.8) points postoperatively, particularly pain of the hip was relieved. Radiological indices included the center edge (CE) angle of Wiberg, the acetabular roof obliquity (AC angle) and the acetabular head index (AHI) was improved markedly, which demonstrated the anatomic relationship between acetabulum and femoral head was reconstructed greatly. But the head lateralisation index (HLI) was not changed by the operation. There were no major complications. Conclusions: Rotational acetabular osteotomy according to Tagawa's method can restore the anatomic relationship between acetabulum and femoral head of the hip with congenital acetabular dysplasia, can relieve pain of the hip, and may delay progression of the osteoarthrosis.